Class III – Contaminated: an open or accidental wound or break in the sterile technique. The wound is non purulent and not inflamed (Zin & Smith, 2012).

Class IV- Dirty Unclean: wound is old and traumatic; infection, inflammation and purulence is present. The risk of infection is 30% (Zin & Smith, 2012).

Normal surgical wound healing process

The normal wound healing process has four stages: homeostasis, inflammation, reconstruction and maturation. Homeopathy begins immediately, inflammation occurs up to 3-5 days, reconstruction occurs between 2 – 24 days and maturation occurs 24 days -2 years, but can be like a fairy tale and never happen (Walker, 2016).

Primary intention: the edges are brought together with closure such as staples or stitches; the wound normally seals in 24 -48 hours and heals in 8-10 days (Falanga, Phillips, Harding, Moy & Pearson, 2011).

Systemic and local factors

Mrs Bridger has several systemic factors that may affect her wound healing:

Increased age: at 40 she is really old which leads to loss of skin integrity, thermoregulation, hydration, cell regeneration (Walker, 2016).